Individual provider Active NPI

Jana M Gray, PT, DPT

  • Physical Therapist
  • North Port, FL
National Provider Identifier
1770750085
Registry record updated Sep 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT26403 Issued in FL
Practice address
6235 Hoffman St
North Port, FL 34287-2285
Phone
(207) 852-5616
NPI assigned
May 15, 2008
Last updated
Sep 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT3303 ME
Physical Therapist 225100000X PT26403 FL Primary

Addresses

Primary practice location

6235 Hoffman St
North Port, FL 34287-2285

Mailing address

3125 Pericles Ave
North Port, FL 34286-7180
Phone (207) 852-5616

Other practice location 1

58 Main St
Bucksport Family Medicine - BHMH
Bucksport, ME 04416-4112
Phone (207) 469-3107

Other names 1

  • Jana Mary Wardwell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT3303MEMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1770750085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 PERICLES AVE",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342867180",
            "telephone_number": "207-852-5616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6235 HOFFMAN ST",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342872285",
            "telephone_number": "207-852-5616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "58 Main St",
            "address_2": "Bucksport Family Medicine - BHMH",
            "address_purpose": "LOCATION",
            "city": "Bucksport",
            "state": "ME",
            "postal_code": "044164112",
            "country_code": "US",
            "telephone_number": "207-469-3107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JANA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-15",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT3303",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT26403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANA",
            "last_name": "WARDWELL",
            "middle_name": "MARY",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Port, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.